基于互联网的全科专业基地与社区协同单位联合病例讨论模式探索及效果评价

Exploration and effect evaluation of the joint grand rounds mode between residency training base of general practice and a community cooperative unit based on the Internet

目的 探索建立基于互联网的全科专业基地与社区协同单位联合病例讨论模式并进行效果评价。方法 自2021年7月至2022年6月,利用中日友好医院国际部远程会诊中心设备,开通与社区协同单位的互联网连接,双方的指导医师以及全科住院医师参与病例讨论,结束后采用问卷调查,由住院医师及指导医师进行评分。评分结果每3个月为1组,分为4组,后3组均以第1组为对照进行两两比较。结果 在网络效果提升方面,第3~4组差异有统计学意义;在互动效果方面,第2~4组都有显著提升,差异有统计学意义;在节约时间成本、节约空间成本方面,差异没有统计学意义;在提高自主学习能力、改善人际交流和沟通能力、提高自身病史采集能力及解决患者的健康问题或疾病方面,第3~4组差异有统计学意义;提高制定诊疗计划能力方面,第4组差异有统计学意义;在促进全科专业基地与社区协同单位的密切联系方面,差异没有统计学差异。结论 基于互联网的全科专业基地与社区协同单位联合病例讨论模式能够有效节省时间和空间,促进全科专业基地与社区协同单位的密切联系,有助于加速培养合格全科医生的进程。

Objective To explore the establishment of the internet-based joint grand rounds mode between standardized residency training base for general practice residents and a community cooperative unit and to evaluate the effect.Methods From July 2021 to June 2022,the remote consultation center of the International Department of our hospital was used to open the Internet connection between the two places,and the teachers and general practice residents of both sides participated in case discussion.After the case discussion,the residents and their teachers were evaluated by questionnaire survey.The scores were divided into 4 groups every 3 months,and the last 3 groups were pairwise compared with the first group.Results In terms of network effect improvement,the difference between groups 3 and 4 was statistically significant compared with the first group.In terms of interaction effect,groups 2 to 4 showed significant improvement,and the difference was statistically significant.There was no statistical significance in saving time cost and saving space cost.In terms of improving autonomous learning ability,helping to improve interpersonal communication skills,improving the ability to collect their own medical history,and better solving patients'health problems/diseases,the difference between groups 3 and 4 was statistically significant compared with the first group.There were statistically significant differences in improving the ability of making diagnosis and treatment plans in group 4.There was no statistical difference in promoting close contact between the residency training base of general practice and the community cooperative unit.Conclusion The internet-based joint grand rounds can effectively save time and space,promote the close connection between residency training bases of general practice and community cooperative units,and help accelerate the process of training qualified general practitioners.